PURPOSE: Foreign body aspiration in the tracheobronchial tree is a common medical emergency in children and represents an important cause of morbidity and mortality. This study was aimed to analyze the clinical spectrum of tracheobronchial foreign bodies in children and to evaluate the causes of late diagnoses. METHODS: A total of 108 patients with foreign body aspiration were recruited in the last 10 years, who had a flexible or rigid bronchoscopic examination. The age, sex, symptoms, causes of aspiration, radiologic findings, and clinical courses were investigated retrospectively. Patients were divided into 2 groups according to the elapsed time from aspiration to a definite diagnosis as early (< or =24 hours after aspiration) and late diagnoses (>24 hours after aspiration). The two groups were compared for clinical courses, radiologic findings, and the duration of admission of early- and late-diagnosed foreign body aspiration. RESULTS: Approximately 80% of the patients were less than 24 months of age and the most common symptoms were the sudden onset of a cough. Hyperinflation or obstructive emphysema (52.8%) and normal chest radiographs (19.4%) were the most frequent radiologic findings. Plain chest radiographies revealed visible foreign bodies in 7.4% of all patients with foreign body aspiration. Nuts were the most common foreign bodies aspirated. Sudden onset of a persistent cough and fever were predominant in the late-diagnosed group.(P<0.05) CONCLUSION: Our results suggest that clinical suspicion upon interviewing is enough to indicate bronchoscopy. The best way to reduce the number of accidents and deaths associated with foreign body aspiration is to promote public prevention polices.
Bronchoscopy ; Child ; Cough ; Delayed Diagnosis ; Diagnosis* ; Emergencies ; Emphysema ; Fever ; Foreign Bodies* ; Humans ; Mortality ; Nuts ; Radiography, Thoracic ; Retrospective Studies ; Thorax

PURPOSE: To evaluate the diagnostic value of gross bloody stools as a predictor of intussusception. METHODS: We reviewed 159 cases retrospectively that had an ultrasound examination for diagnosis of intussusception from January 2001 to December 2003 at Ilsin Christian Hospital. We compared each symptom and assessed the diagnostic value of gross bloody stools in the patients with suspected intussusception. RESULTS: Thirty-six of the 159 patients had intussusception. Of 36 patients with intussusception, 19 (52.8%) children were male and 28(77.8%) children were younger than two years. The most common symptom was intermittent abdominal pain or irritability. But its frequency among the intussusception (24.2%) was lower than frequency of gross bloody stools(50.9%). The sensitivity, specificity, positive predictive value(PPV) and negative predictive value(NPV) of gross bloody stools in patients with suspected intussusception were as follows; sensitivity=77.8%(95% CI 60.8-89.9), specificity=78.0%(95% CI 69.7-85.0), PPV=50.9%(95% CI 37.1-64.6), NPV=92.3%(95% CI 85.4-96.6)(Diagnostic accuracy 78.0 %; 95% CI 70.7-84.2). CONCLUSION: It is useful for diagnosis of intussusception to confirm the presence of gross blood in stools.
Abdominal Pain ; Child ; Diagnosis ; Humans ; Intussusception* ; Male ; Retrospective Studies ; Sensitivity and Specificity ; Ultrasonography

OBJECTIVES: The objective of this study was to examine the relations between total vegetable and Kimchi intakes and the risk of metabolic syndrome (Mets) in Korean adults. METHODS: This study used dietary intake and health data of 6668 subjects aged 20 years and over from the 2010–2011 Korea National Health and Nutrition Examination Survey (KNHANES). Daily intakes of total vegetables and Kimchi were assessed by 24-hour recall data. The odds ratio of Mets risk according to daily intake of vegetables and Kimchi was analyzed, respectively. RESULTS: The highest consumption of total vegetables was associated with a lower risk of abdominal obesity (multivariable adjusted OR=0.56, 95% CI: 0.33, 0.93) in men and lower risk of Mets (multivariable adjusted OR=0.67, 95% CI: 0.47, 0.94) in women. Kimchi consumption was not related to the risk of Mets in both men and in women. However, a higher intake of Kimchi was associated with an increased risk of elevated blood pressure (Q1 vs Q5, multivariable adjusted OR=1.34, 95% CI: 0.95, 1.90, P for trend= 0.0261) in women. CONCLUSIONS: A higher intake of vegetables was associated with decreased risk of abdominal obesity and Mets in both men and women, respectively. A higher consumption of Kimchi was not related to the risk of Mets in both in men and in women. However, a higher intake of Kimchi was associated with an increased risk of elevated blood pressure in women.
Adult* ; Blood Pressure ; Female ; Humans ; Korea* ; Male ; Nutrition Surveys* ; Obesity, Abdominal ; Odds Ratio ; Vegetables*

OBJECTIVE: To evaluate the therapeutic effect of botulinum toxin A (BTX-A) injection on spastic gastrocnemius (GCM) and tibialis posterior muscles (TPo) by using the foot pressure measurement system (FPMS). METHODS: Eighteen ambulatory CP patients were recruited in this study. BTX-A was injected into the GCM at a dose of 6-12 units/kg and TPo at a dose of 4-9 units/kg according to the severity of equinus and varus deformity. Foot contact pattern, pressure time integral (PTI), coronal index using the FPMS and Modified Ashworth Scale (MAS), and visual inspection of gait pattern were used for evaluation of the therapeutic effect of BTX-A injection. Clinical and FPMS data were statistically analyzed according to the muscle group. RESULTS: A significant decrease in the MAS score of the GCM and TPo was observed, and spastic equinovarus pattern during gait showed improvement after injection. The GCM+TPo injection group showed a significant decrease in forefoot, lateral forefoot pad, and lateral column PTI, and a significant increase in hindfoot PTI and coronal index. In the GCM only injection group, forefoot PTI and lateral column PTI were significantly decreased and hindfoot PTI was significantly increased. The TPo only injection group showed a significant decrease in lateral column PTI and a significant increase in the coronal index. Change in PTI in the hindfoot showed a significant correlation with the change in MAS score of the GCM. Change in PTI of the lateral column and coronal index showed a significant correlation with the change in MAS score of the TPo. CONCLUSION: The FPMS demonstrated the quantitative therapeutic effect of BTX-A on abnormal pressure distribution in equinovarus foot in detail. The FPMS can be a useful additional tool for evaluation of the effect of BTX-A injection.
Botulinum Toxins* ; Cerebral Palsy* ; Clubfoot* ; Congenital Abnormalities ; Foot* ; Gait ; Humans ; Muscle Spasticity* ; Muscles

This study was conducted to examine the effect of chronic low dose organic solvent exposures in the industries towards then neurobehavioral functions of workers subjective symptoms on neurobehavioral function as well as a visual reaction time test (Flicker test) were administered to 94 exposed and 162 unexposed workers in a oil refinery and some other auto-repair shops. The results obtained were as follows: 1. Symptom complaints were higher and Flicker test values were lower in exposed workers than in unexposed workers. 2. Flicker values were inversely correlated with urinary Hippuric acid concentration in exposed workers (r=-0.26, p<0.05). 3. Flicker values were inversely correlated with subjective symptom score (r=-0.15, p<0.05). Low Flicker value were also related with some subjective symptoms such as "Dimmed vision", "Nightmare", "weakness on extremity" in workers as a whole. While symptoms of "Dimmed vision", "Nightmare" only observed among exposed workers.
Reaction Time

This investigation was designed to analyze the degree of dental compensation according to horizontal components of craniofacial skeleton and to investigate correlation between dental compensation and craniofacial pattern in skeletal class III malocclusion. The material selected for this study consisted of standard lateral cephalogram of 59 subjects in normal occlusion group, 91 subjects in mild skeletal class III malocclusion group and 58 subjects in severe skeletal class III malocclusion group. The mild skeletal class III malocclusion group was divided into two groups, one was class III malocclusion without anterior crossbite group and the other was class III malocclusion with anterior crossbite group. The data were analyzed by Quick-ceph image program. The results were as follows. 1. Mild skeletal class III malocclusion without anterior crossbite group showed the most labial inclination of upper incisors, followed by severe skeletal class III malocclusion group and mild skeletal class III malocclusion with anterior crossbite group, the Latter showing the least. The amount of lingual inclination of lower incisors was the largest in severe skeletal class III malocclusion group, and there was no statistically significant difference between mild skeletal claw III malocclusion without anterior crossbite group and mild skeletal class III malocclusion with anterior crossbite group. 2. There were little differences in vertical skeletal structure between mild skeletal class III malocclusion without anterior crossbite group and mild skeletal class III malocclusion with anterior cwssbite group, they showed statistically significant differences in the upper incisors measurements. 3. The measurements of lower incisors in mild skeletal class III malocclusion without anterior crossbite group and upper incisors in mild skeletal class III malocclusion with anterior crossbite group represented a high correlation with skeletal structure. Especially, deltaIMPA and deltaFMIA of lower incisor measurements, and deltaU1-FR deltaUi-SN of upper incisor measurements showed high correlation with skeletal structure in each group. 4. deltaIMPA and deltaFMIA of lower incisor measurements showed high correlation with skeletal structure in all groups. deltaUI-FH, deltaU1-SN and Ui-facial plane(mm) of upper incisor measurements represented higher correlation with skeletal structure than any other upper incisor measurements.
Animals ; Compensation and Redress* ; Hoof and Claw ; Incisor ; Malocclusion* ; Skeleton

PURPOSE: We evaluated the prognostic factors of open globe injuries in children and adolescents, and compared the ocular trauma score (OTS) and pediatric penetrating ocular trauma score (POTS). METHODS: We performed a retrospective review of 77 children under 18 years of age who visited our clinic with open globe injuries between May 1993 and April 2014. We investigated the factors that may affect final visual acuity. We also compared the OTS and POTS using receiver operating characteristic curves as a method to predict final visual acuity. RESULTS: By univariate analysis, an initial visual acuity less than 20/200, globe rupture, wound size greater than 7.0 mm, retinal detachment, lens dislocation, and total number of operations contributed to worse visual outcomes (<20/200). Conversely, central corneal involvement, traumatic cataract, wound size less than 7.0 mm, and initial visual acuity greater than 20/200 were better prognostic indicators (≥20/32). Both OTS and POTS had diagnostic value as a predictor of final visual acuity, although there were no statistically significant differences between the two scoring systems. CONCLUSIONS: Initial visual acuity and wound size are important prognostic factors for the final visual acuity in children and adolescent, following open globe injuries. Both OTS and POTS are reliable prognostic models for open globe injuries in children and adolescents.
Adolescent ; Cataract ; Child ; Humans ; Lens Subluxation ; Methods ; Retinal Detachment ; Retrospective Studies ; ROC Curve ; Rupture ; Visual Acuity ; Wounds and Injuries

Gastric metastasis from invasive lobular breast carcinoma is rare. Mostly gastrointestinal metastasis presents as one among multiple metastases, several years after primary diagnosis of breast carcinoma. Herein, we report a synchronously diagnosed gastric metastasis from invasive lobular carcinoma, mimicking primary gastric linitis plastica with pyloric obstruction. We reviewed clinical and pathological findings of gastric carcinoma metastatic from the breast. In particular, we focused on immunohistochemical studies of selected antibodies, including those for estrogen receptors, gross cystic disease fluid protein-15, and caudal-type homeobox transcription factor 2, for accurate differential diagnosis. Clinical suspicion, repeat endoscopic biopsy, and detailed histological analysis including immunohistochemistry are necessary for diagnosis of gastric carcinoma metastatic from the breast.
Antibodies ; Biopsy ; Breast Neoplasms* ; Breast* ; Carcinoma, Lobular ; Diagnosis ; Diagnosis, Differential ; Genes, Homeobox ; Immunohistochemistry ; Linitis Plastica ; Neoplasm Metastasis* ; Receptors, Estrogen ; Stomach ; Transcription Factors

The purpose of this study was to investigate the relationship among serum leptin, nutritional status, and the obesity indices of 55 obese children in Daegu and Kyungpook area. Obesity was defined as fat percentage that exceed 25% of body fat mass. Energy and nutritional status were tended to be low, and dietary intake of calcium and iron were less than any other nutrients in all the subjects. Especially, beverage intake of obese group was more than non-obese group. The leptin level were significantly correlated with %RDA of energy (0.41, p < 0.001), protein (0.44, p < 0.001), phosphate (0.40, p < 0.001), iron (0.37, p < 0.001), vitamin A (0.31, p < 0.01), thiamin (0.40, p < 0.001), riboflavin (0.26, p < 0.05), niacin (0.51, p < 0.001), and vitamin C (0.24, p < 0.05). The leptin level were significantly correlated with MAR (mean adequacy ratio, r = 0.43, p < 0.001) and INQ (index of nutrient quality) of thiamin (r = 0.22, p < 0.05). Multiple regression analysis showed that %RDA of niacin in obese group (R2 = 0.208, p = 0.001) and total subjects (R2 = 0.257, p = 0.000), MAR (p = 0.003) and INQ (p = 0.048) of niacin in obese group (R2 = 0.255) and MAR (p = 0.000) and INQ of Ca (p = 0.024) in total subjects (R2 = 0.231) may be important independent predictors to leptin level. MAR showed a significantly positive correlation with %fat (r = 0.42, p < 0.01), BMI (r = 0.46, p < 0.01), RW (r = 0.44, p < 0.01), WHR (r = 0.39, p < 0.01) and, %RDA (p < 0.05, p < 0.01). These data indicated relationships among leptin level, nutrient intake, %RDA, MAR, and INQ in children.
Adipose Tissue ; Ascorbic Acid ; Beverages ; Calcium ; Child* ; Daegu ; Gyeongsangbuk-do ; Humans ; Iron ; Leptin* ; Niacin ; Nutritional Status ; Obesity ; Riboflavin ; Vitamin A

Progressive ischemia can result in gangrenous changes of the tissues. Most commonly the digits are affected initially, but progression to the hand is not unusual. Small amounts of infection superimposed on a severe chronic ischemic state can progress very rapidly to gangrene. Clinically, dry and wet gangrene should be differentiated. Dry gangrene represents mummification of tissue, and active purulent tissue and cellulitis are absent. Wet gangrene is characterized by active infection with cellulitis and purulent tissue planes and is an indication for urgent amputation to prevent ascending infection. We experienced a case of dry gangrenous extremity due to septic shock after anethesia.
Amputation ; Cellulitis ; Extremities* ; Gangrene ; Hand ; Humans ; Ischemia ; Shock, Septic*